Dominitz Jason A, Spiegel Brennan
VA Puget Sound Health Care System, University of Washington School of Medicine, Seattle, Washington, USA.
Department of Health Services Research, Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Cedars-Sinai Health System, Los Angeles, California, USA.
Am J Gastroenterol. 2016 May;111(5):730-2. doi: 10.1038/ajg.2016.103.
The colonoscopy quality assurance movement has focused on a variety of process metrics, including the adenoma detection rate (ADR). However, the ADR only ascertains whether or not at least one adenoma is identified. Supplemental measures that quantify all neoplasia have been proposed. In this issue of the American Journal of Gastroenterology, Aniwan and colleagues performed tandem screening colonoscopies to determine the adenoma miss rate among high-ADR endoscopists. This permitted validation of supplemental colonoscopy quality metrics. This study highlights potential limitations of ADR and the need for further refinement of colonoscopy quality metrics, although logistic challenges abound.
结肠镜检查质量保证运动聚焦于多种过程指标，包括腺瘤检出率（ADR）。然而，ADR仅确定是否至少发现了一个腺瘤。已经提出了量化所有肿瘤的补充措施。在本期《美国胃肠病学杂志》中，阿尼万及其同事进行了串联筛查结肠镜检查，以确定高ADR内镜医师中的腺瘤漏诊率。这使得结肠镜检查补充质量指标得以验证。尽管存在诸多后勤方面的挑战，但这项研究凸显了ADR的潜在局限性以及进一步完善结肠镜检查质量指标的必要性。
